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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seven patients with primary osteomyelitis of the chest wall are described. All patients presented with pain at the site of infection, and four patients had a tumor-like mass that could easily be confused with a neoplastic process. All were heroin addicted and pseudomonas was the most common organism cultured. Conservative management with antibiotics for a minimum of 4 weeks is recommended with operation assuming a secondary role, namely, to assist in the initial diagnosis or in the form of limited resection of residual sinuses. Primary wide resection is discouraged.
J Thorac Cardiovasc Surg 1979 Jan
PMID:The role of surgery in primary osteomyelitis of the chest wall. 75 64

Profundaplasty has been performed on 58 limbs (45 primary and 13 secondary) in 45 men. Thirty-four of these had incapacitating claudication, 14 rest pain, and 10 either gangrene or ischemic ulceration. In 19 treated by profundaplasty alone there were no deaths but three subsequently had amputation for ischemic pain. In 39 with profundaplasty plus a proximal operative augmentation there were two (6.7%) operative deaths and one (3.4%) late death but only one extremity had to be amputated. Radionuclide flow studies confirmed physical and arteriographic findings. After profundaplasty alone and profundaplasty plus aortofemoral bypass there was moderate increase in calf blood flow but in only those with a patent superficial femoral did the flow studies return to normal. Profundaplasty is an important addition to the armamentarium of the vascular surgeon in dealing with arteriosclerotic insufficiency of the lower extremities.
J Cardiovasc Surg (Torino)
PMID:The role of primary and secondary profundaplasty in the treatment of vascular insufficiency. 83 92

Although there is no statistical proof of the efficacy of coumarin drugs in the therapy of acute myocardial infarction, the numbers of patients at risk from thromboembolism are sufficiently great and the favorable clinical and pathologic impressions are sufficiently strong that, conversely, the possibility of benefit cannot be excluded. This delicate balance is indeed a Hobson's Choice. In this therapeutic dilemma, we would interpret one acceptable course in regard to the use of anticoagulants among patients with acute myocardial infarction as follows: all patients with proved acute myocardial infarction should be treated with anticoagulants while hospitalized unless there are relative or absolute contraindications to the therapy or deficiencies in laboratory facilities. Patients with questionable infarcts should be treated with anticoagulants only until the diagnosis is established or rejected. If the latter occurs, the administration of the drug should be discontinued. When, in a patient suspected of having an acute myocardial infarction, there is reason to believe that the pain may be due to pericarditis, dissecting aneurysm, or gastrointestinal abnormalities, anticoagulant therapy should be withheld until this is resolved.
Cardiovasc Clin 1977
PMID:Antithrombotic agents are indicated in the therapy of acute myocardial infarction. 84 87

From January 1, 1974, to January 1, 1976, 15 premenopausal women aged 35-48 years were treated for complaints of intermittent claudication. The pain generally occurred in the calves, and none felt pain at rest. All the patients used an oral contraceptive composed of a progestative and an estrogenic component, with average duration of use of 7 years. All the women were of small stature with normal weight. A systolic souffle could be heard above the bifurcation of the aorta. In all patients an angiographic examination revealed local obstruction in the distal aorta, a gracile vascular system, and the absence of defects of the arteries outside the distal part of the aorta. No defects were found in other vessels, and there were no indications that hypertension, excessive smoking, hypercholesterolemia, or hyperlipidemia played a role in the cases. Local end-artereictomy of the distal aorta via a median laparotomy was the treatment. The part of the aorta wall that was removed showed signs of arterioschlerosis obliterans. There were no complaints of symptoms during the follow-up which ranged from 3 months to 2 years. A correlation is suggested between the defects of the distal aorta and prolonged use of oral contraceptives.
J Cardiovasc Surg (Torino)
PMID:Intermittent claudication in premenopausal women. A correlation with the long-term use of oral contraceptives? 86 65

Postoperative pain is an important factor in the management of children undergoing thoracotomy. Intercostal nerve block has been used in adult patients, but its applicability in the pediatric age group has not been previously evaluated. Eighty-nine children (85 girls and 31 boys) aged 6 months to 16 years (mean age 4.7 years) underwent ligation of a patent ductus arteriosus (PDA) through a left thoracotomy. Twenty-nine children received intercostal blocks with bupivacaine from the level of the second to sixth thoracic vertebrae. Sixty cases constituted the control group. The patients with intercostal block had fewer doses of pain medication postoperatively, 2.7 mean (0 to 9), than did the control patients, 3.9 mean (0 to 21). The mean hospital stay was shortened in the patients with nerve block, 5.1 days versus 7.3 days for the control group. No ill effects of bupivacaine were noted. We conclude that intercostal nerve block is a valuable procedure reducing the need for postoperative analgesia and shortening hospital stay.
J Thorac Cardiovasc Surg 1977 Aug
PMID:Kindness pays dividends: the medical benefits of intercostal nerve block following thoracotomy. 88 80

Application of bradykinin to the exposed ventricular surface of the dog heart elicits a reflex cardiovascular response which includes a rise in blood pressure, tachycardia, renal vasoconstriction and muscular vasodilation. The reflex response depends on the dose of bradykinin and is increased by concomitant application of prostaglandin E1 or E2 and reduced by indomethacin. Temporary occlusion of the coronary artery supplying the area of the ventricle under study also sensitized the heart to topical application of bradykinin. Bradykinin and prostaglandins are released by the heart during ischaemia. We suggest, therefore, that bradykinin and prostaglandins acting in concert are the natural stimulus for excitation of the sensory receptors signalling the pain of myocardial ischaemia. We also suggest that the nervous reflex which arises from activation of sympathetic sensory nerve endings is the mechanism subserving the cardiovascular events which accompany anginal attacks.
Cardiovasc Res 1976 May
PMID:An excitatory nociceptive cardiac reflex elicited by bradykinin and potentiated by prostaglandins and myocardial ischaemia. 95 16

Diagnostic pacing has proven useful for the study of a great variety of clinical problems. Rapid atrial pacing is an excellent means of stressing the heart, particularly in patients with ischemic heart disease. Pacing-induced tachycardia has been used to provoke typical coronary pain and to produce hemodynamic, metabolic, and left ventricular contractile changes in patients with coronary artery disease. Because this heart stress is reproducible, it has also been valuable in assessing response to medical and surgic al therapy in patients with angina. Electrophysiologically, pacing has been used to clarify mechanisms of normal and abnormal function of the sinus node and A-V conduction. The pre-excitation states have been more precisely defined, and the introduction of programmed electrical stimuli into the cardiac cycle has helped elucidate the nature of re-entry supraventricular tachycardias.
Cardiovasc Clin 1975
PMID:Diagnostic uses of electrical pacing. 110 Feb 46

Intercostal nerves were injected with 10 per cent annomium sulfate in 41 patients (52 total sets of injections) for management of intercostal neuralgia from radical mastectomy (six blocks), thoracotomy (20 blocks), or unknown etiology (26 blocks). Five patients failed to return for follow-up evaluation and could not be located. Sixty per cent (28/47) of the treatments produced complete or nearly complete (excellent) relief of pain. Excellent pain relief persisted for more than 20 days after 22 treatments and for more than 90 days after seven treatments. Postblock neuritis never occurred. We conclude that intercostal nerve block with 10 per cent ammonium sulfate effectively relieves intercostal neuralgia and is not associated with postblock neuritis. We therefore believe that ammonium sulfate nerve blocks should be administered for treatment of intercostal neuralgia before phenol or alcohol nerve blocks or a surgical procedure.
J Thorac Cardiovasc Surg 1975 Mar
PMID:Treatment of intercostal neuralgia with 10 per cent ammonium sulfate. 111 40

Since January, 1972, the authors have operated upon 4 patients with idiopathic diffuse exophageal spasm. Clinical details and barium studies are included. Extramucosal myotomy extending from the gastric fundus to the aortic arch was done in each case. Pre- and postoperative manometric studies were carried out in all. After operation in each patient the dysphagia and substernal pain disappeared and in 3 patients radiological patterns changed. The myotomy was associated with marked fall of contractile wave pressures in the body of esophagus. The basal pressures of the esophageal body elevated, in 2 cases fell after the myotomy; in 2 with normal preoperative pressure it remained unchanged. At the lower esophageal sphincter the resting and yield pressures remained similar to the preoperative readings but the myotomy produced a disappearance of the relaxation and contraction pressure. The authors conclude that with myotomy they cannot correct the nature of the functional disorder but, by reducing the amplitude of the waves and lowering the resting pressure if elevated, they can relieve the patient's symptoms.
J Thorac Cardiovasc Surg 1975 Jul
PMID:Pre- and postoperative manometric studies in diffuse esophageal spasm. 115 94

As shown by the inotropic changes, the sympathetic discharge on the heart, is selectit syndrome. In the steady state the electrocardiogram shows flat, diphasic, or "tucked' T waves. Mental stimulation or isoproterenol, and, respectively, pain or beta blockade induce changes of the repolarization phase divergent from steady state. The former causes ST depression and deep T-wave inversion and the latter fully normalizes the repolarization phase. It is concluded that the electrical activity of the heart is directly influenced by the adrenergic drive in this disorder, and that different stressful factors can alter the repolarization phase in opposite ways in relation to the influence of the stimulus on the cardiac sympathetic tone.
Cardiovasc Res 1975 May
PMID:Stress-induced and sympathetically-mediated electrocardiographic and circulatory variations in the primary hyperkinetic heart syndrome. 117 81


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